How can we increase uptake of flu vaccinations amongst health care workers?
Evidence Hub
Evidence briefing: How can we increase uptake of flu vaccinations amongst health care workers?
About this briefing
This briefing is aimed at professionals involved with winter pressure planning in NHS providers or commissioners, or those with responsibility for flu vaccination roll-out in the health and care system.
You can download a more detailed briefing document at the bottom of this page.
Quick read summary
Flu vaccination rates are in decline in England. Only 37.5% of health care workers in NHS trusts received a vaccine in the 2024-2025 season (down from 42.8% the previous year), and 51.5% of health care workers in GP practices (down from 61.8%). This puts staff and patients at risk for seasonal influenza, potentially increasing staff sickness rates and workload pressure to maintain services during periods of high demand. Young people, females, and nurses were less likely to be vaccinated. Older people with more time in the profession were most likely to be vaccinated.
Our evidence review found that barriers to uptake to flu vaccination by healthcare workers relate to a lack of confidence, motivation and access.
Confidence
Limited confidence is caused by lack of knowledge about flu, risks and transmission, beliefs around ineffectiveness, concerns about side-effects and missing time of work, and misinformation on social media.
Educational interventions can improve confidence, including materials such as leaflets, posters and videos. These should include information on the benefits of the vaccine for staff, their families and patients. Issues around misinformation should be addressed and available before vaccinations are being offered.
Motivation
Motivation is strongly linked to trust in the organisation, with leadership (including lead nurses) setting the example in promoting and taking vaccines. Open and honest conversations with management should be prioritised, and opportunities for workers to talk to a reliable person in their organisation (e.g. doctors) about their vaccination concerns, side-effects and uncertainties.
Rewards and (financial) incentives also help, such as paid time off, free refreshments, or other reward items such as badges, pens and mugs.
Access
Poor supply of vaccines and lack of time are key barriers to access.
To improve access, vaccinations should be offered at different work sites including canteens and entrances, at a range of times on several days, include evenings, night shifts, and weekends. Drop-in sessions without appointment, mobile vaccinators (trolleys), and peer vaccination (providing toolkits to departments) also maximise ease of vaccination.
Although effective in driving uptake, there is strong opposition to mandatory vaccination, with concerns around autonomy and ethical implications, reducing trust in the organisation and motivation to get vaccinated in the longer term.
Finally, publishing vaccination rates by team, displaying posters in their department when they reach their required uptake motivated staff and helps to target areas with low uptake.
Key recommendation: Combining interventions that target confidence, motivation and access is most effective. Even where health care workers are both confident and motivated to get vaccinated, there needs to be barrier-free access to result in actual uptake.
Eight practical suggestions
- Vaccine ambassadors (featured on posters/desktop screensavers) to communicate key messages on importance of getting vaccinated.
- Vaccination champions – Recruit trusted staff peers to act as vaccination advocates. Provide them with tailored training and messaging to engage with hesitant colleagues.
- Pop up clinics and roving teams including early starts and late finishes
- Bespoke sessions offered for hard-to-reach staff groups.
- Offering paid time off for vaccination appointments or extra day of annual leave offered when vaccinated.
- Canteen vouchers given out following vaccination or entered into a raffle for £50 voucher.
- Data-driven targeting; using workforce analytics to identify departments and clinics with poor uptake. Tailor communications and vaccination times to address specific barriers.
- Not counting vaccine-related absences in absence records or towards any ‘trigger’ system.
This briefing was produced by the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC).
It was developed as part of a Knowledge Mobilisation sprint over August-September 2025 by the NIHR ARC NENC Knowledge Mobilisation team, in collaboration with Integrated Care Board in the North East and North Cumbria, to support their winter pressure planning.
If you would like support from the ARC NENC Knowledge Mobilisation team, get in touch at [email protected]